title: Cost-effectiveness of personalized plaque control for managing the gingival manifestations of oral lichen planus: a randomized controlled study.
abstract: OBJECTIVE
  To undertake cost-effectiveness and cost-benefit analyses of an intervention to improve oral health in patients presenting with the gingival manifestations of oral lichen planus (OLP).
  
  
  METHODS
  Eighty-two patients were recruited to a 20-week randomized controlled trial. The intervention was personalized plaque control comprising powered tooth brushing and inter-dental cleaning advice. The primary outcome measure was the oral health impact profile (OHIP) with secondary outcomes of pain, plaque index, mucosal disease score and cost-effectiveness. Private cost data and stated willingness-to-pay (WTP) values for treatment were obtained from intervention patients at 20 weeks.
  
  
  RESULTS
  Overall, 81% of intervention patients showed improvement in both plaque index and mucosal disease score at 20 weeks compared to 30% of controls that continued with their usual plaque control regimen. All intervention group patients stated a positive WTP value. The mean net value of the treatment was £172 compared to the incremental cost of the treatment estimated at £122.75. The cost-effectiveness analysis resulted in an incremental cost-effectiveness ratio of £13 per OHIP point.
  
  
  CONCLUSIONS
  The tailored plaque control programme was more effective than control in treating the gingival manifestations of oral lichen planus. The programme is cost effective for modest values placed on a point on the OHIP scale and patients generally valued the treatment in excess of the cost.
authors.affiliation: School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK. simon.stone@ncl.ac.uk
authors.forename: Simon J
authors.initials: SJ
authors.lastname: Stone
authors.forename: Giles I
authors.initials: GI
authors.lastname: McCracken
authors.forename: Peter A
authors.initials: PA
authors.lastname: Heasman
authors.forename: Konrad S
authors.initials: KS
authors.lastname: Staines
authors.forename: Mark
authors.initials: M
authors.lastname: Pennington
mesh_terms: D001294:Attitude to Health; D017281:Cost of Illness; D003362:Cost-Benefit Analysis / Q000191:economics; D003742:Dental Devices, Home Care; D003773:Dental Plaque / Q000191:economics / Q000517:prevention & control*; D003774:Dental Plaque Index; D004867:Equipment Design; D005260:Female; D005382:Financing, Personal; D005500:Follow-Up Studies; D005882:Gingival Diseases / Q000191:economics / Q000628:therapy*; D006801:Humans; D017676:Lichen Planus, Oral / Q000191:economics / Q000628:therapy*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009909:Oral Health; D010147:Pain Measurement; D057285:Precision Medicine / Q000191:economics; D011788:Quality of Life; D014099:Toothbrushing / Q000191:economics* / Q000295:instrumentation; D016896:Treatment Outcome
keywords: cost-effectiveness; desquamative gingivitis; oral health impact profile; oral lichen planus; plaque control